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Australian Journal of Pharmacy : November 2006
opinion your say T HE Australian Journal of Pharmacy welcomes feedback from its readers. When sending a letter to the editor, please include your name, address and a contact telephone number should the editor require clarification. Ibuprofen must be removed from supermarkets Editor, Pharmacists will be aware of the recent survey and media release by the Kidney Health Australia, which estimated that one in 10 people who take ACE or A2RBs with a diuretic, may be at risk of poten- tially fatal kidney failure, from the inter- action, known as the ‘triple whammy’. These types of combination tablets are now the most commonly used of the anti- hypertensive agents. Therefore, it is not surprising that I and my colleague hospi- tal pharmacists frequently see patients who are taking these medications. They have bought the non-steroidal anti- inflammatory drug (NSAID) ibuprofen at a supermarket, but have not mentioned this to their doctor or pharmacist. Although the latest warnings by Kidney Health Australia follow hard on the heels of the second Adverse Drug Reactions Advisory Committee (ADRAC) warning in three years highlighting the potential life- threatening outcome that may occur from combining these drugs, it is obvious that many cases may not be reported. In discussing the well-known, adverse gastrointestinal effects of NSAIDs, the Gut Foundation recently noted: ‘If you have occasional cases scattered through the community, it’s not going to reach the consciousness of either the medical pro- fession or the bureaucrats’. In the case of iatrogenic renal failure, this is because the patient won’t be aware in the first place that by self-medicating with NSAIDs, they are putting their life at risk. If they end up with kidney failure, no one at that stage is likely to make the potentially lethal connection between the ibuprofen that they bought at the super- market and their subsequent kidney fail- ure. Unfortunately, the National Drugs and Poisons Schedule Committee which allowed ibuprofen to be sold in super- markets in 2003, has repeatedly refused to reverse its ill-considered decision. Now in the face of these dramatically changed circumstances, of not one but two ADRAC reports, a damning survey and a plea by renal experts, highlighting the risks of life-threatening renal failure from self-selection of NSAIDs in at-risk patients, ibuprofen must be removed from supermarkets immediately! Ron Batagol Pharmacist Nunawading Vic Zanamivir missing in action Editor, I was delighted to read the article pub- lished in the Australian Journal of Pharmacy titled ‘current drug information, under- standing the influenza virus’. I found the article to be informative and useful. However, I respectfully suggest that there is an omission in Tables One and Two. In both cases only oseltamivir is listed under ‘prevention’ or ‘prophylaxis’. Please note that the other drug high- lighted in these tables, zanamivir, is also approved for prophylaxis and is effective in preventing influenza (as noted correctly in the text of the article). Zanamivir is, of course, the world’s first NAI and was discovered in Australia. Simon P Tucker, PhD Vice-president, Research Biota Holdings Limited Editor’s note: I’d like to thank Dr Tucker for highlighting this omission. 10 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL 87 NOVEMBER 2006 Medicare welcomes Guild support for online claiming for PBS EDICARE Australia has wel- comed the recent announcement by the Pharmacy Guild of Australia of its strong support for online claiming for the Pharmaceutical Benefits Scheme (PBS). Online claiming will assess prescrip- tions, including a customer’s eligibility for the PBS, at the point of dispensing and will allow errors to be corrected on the spot. It will inform pharmacies whether the claim is payable before the customer actu- ally receives the medicine. Medicare Australia’s CEO, Catherine Argall, said the Guild’s support for online claiming recognises the significant improvements made to the service since it was introduced in late 2004. M ‘Main improvements are better pay- ment reconciliation processes and support arrangements for pharmacies. We have also enhanced the performance and sta- bility of the system,’ Ms Argall said. More than 200 pharmacies are using the online claiming channel. For more information call 132 290 or visit www.medicareaustralia.gov.au/ providers. ¦ Call for realism on ice A realistic, comprehensive, bipartisan strategy on combating the problem of methamphetamines is needed in Aus- tralia, according to the Association for Prevention and Harm Reduction Pro- grams Australia (Anex). According to Anex chief executive offi- cer John Ryan, politicising the ice issue poses a risk of ‘dumbing down’ the com- plicated community and individual issues associated with the drug. ‘We are talking about families, individuals and our com- munities—many of whom are reaching out for realistic services that are often severely underfunded,’ Mr Ryan said. Anex recently organised the Aus- tralasian Amphetamine Conference, which called for co-ordination of resources, national education, urgent training of all front-line workers and iden- tification of essential research and part- nerships between existing services. ¦